Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2020

Baroness Jolly Excerpts

Thursday 10th December 2020 Grand Committee

[Baroness Jolly (LD) [V]]

My Lords, I welcome the Government’s move to introduce this legislation, which simplifies and standardises the regulation of private sector testing for Covid-19. The Minister’s introduction was most helpful and I hope that he manages to avoid the virus. For the asymptomatic who require a test and can afford it, making tests accessible and of a high standard is extremely important.

We have two pieces of legislation before us today. I turn first to the health protection regulations. This instrument is to ensure that all private providers offering Covid-19 testing services on a commercial basis in England provide services that are of a sufficiently high standard. It is designed to simplify the complex regulatory environment for Covid-19 testing. Under the proposal, the United Kingdom Accreditation Service would provide a national accreditation service on the wider aspects of testing, including the processing, analysing and reporting of tests. The SI imposes an obligation on providers to make an application to a three-stage scheme to ensure consistency of standards; to offer assurance to the public about the quality of private tests through UKAS; and to ensure that the testing organisation would get accreditation from UKAS.

The second SI removes all coronavirus testing from the CQC regulatory environment, as I outlined above. But let us be clear: when anyone has Covid-19 symptoms, or has been asked to take a test by the local council, there are no problems. They can go the testing station or apply for the testing kit and there will be no cost. The free testing service is not for proof of freedom from Covid for travel or other purposes, such as being sure that you are safe to mix with friends and family at Christmas.

These tests have to be purchased privately and I wonder what their margin is. According to Which? last week, the going rate for a private test from a high street pharmacy is about £120. If a negative test is a prerequisite for a flight or something you feel you should do to make a family Christmas safe, the private sector is your only option, but for many, of course, that is not financially possible and so risks may be taken. Certainly, when our children were small, there was no way we could have afforded the equivalent of nearly £500; likewise if you had hoped to get away over the Christmas holidays for some sun. I note that the CMO has said that he is anticipating a surge in cases after Christmas. Testing might be nice to have, but masks will be essential.

It looks as though one of the beneficiaries of these SIs could be pharmacies. I have two points that I would like clarification on from the Minister. First, the Health Secretary has noted that 25% of individuals taking NHS tests were not eligible. This legislation seeks to enable private testing to complement government testing and reduce pressure on test and trace. Could the Minister please provide more detail on this? Specifically, how does increasing the accessibility of private sector testing allow the Government to shift to a wider testing strategy and, crucially, the testing of asymptomatic individuals?

Secondly, someone who cannot afford a private test from a high street pharmacy and cannot access NHS testing will be left in isolation, often without appropriate financial support. In general, we will always be limited by capacity to some extent, but it is vital that we move away from the current model of testing only those with symptoms. Mass testing in Liverpool showed that testing those without symptoms can help us to interrupt the flow of transmission. I would like reassurance from the Minister that encouraging private sector testing will not create or exacerbate inequalities.

A well-off asymptomatic individual may be able to end a period of isolation and return to work or travel by paying for a private test. As with all areas involving communication with the public, we have to be aware that an Anglo-Saxon approach is probably not ideal. This is a contributing factor to the low isolation compliance—a huge challenge in controlling the virus. What is the wider strategy to ensure that the NHS and Lighthouse Labs work in harmony so that those who most need tests can access them free of charge?

Of course, I appreciate that working with the private sector is vital in this pandemic and making the pathway to test provision simpler may increase competition and reduce prices. This would: allow providers to enter the market more quickly and at lower cost; provide more comprehensive oversight of the entire market; and ensure quality of testing standards. In addition,

“novel, non-clinical testing technologies and methods”

would not need to be individually exempted from regulation.

I will finish where I started: for those who are asymptomatic who require a test and can afford it, making tests accessible and of a high standard is extremely important. However, we must be wary of exacerbating inequalities through access to testing. How do the Government intend to prevent this? I look forward to the Minister’s comments.